Provider Demographics
NPI:1508222589
Name:LADECKY, BRITTANY (SLP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:LADECKY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 S AIR DEPOT BLVD STE 17
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-4860
Mailing Address - Country:US
Mailing Address - Phone:405-455-6868
Mailing Address - Fax:800-856-0132
Practice Address - Street 1:1212 S AIR DEPOT BLVD STE 17
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4860
Practice Address - Country:US
Practice Address - Phone:405-455-6868
Practice Address - Fax:800-856-0132
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKSP5683235Z00000X
COSLP.0001881235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist